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Multimorbidity, polypharmacy, and COVID-19 infection within the UK Biobank cohort
BACKGROUND: It is now well recognised that the risk of severe COVID-19 increases with some long-term conditions (LTCs). However, prior research primarily focuses on individual LTCs and there is a lack of data on the influence of multimorbidity (≥2 LTCs) on the risk of COVID-19. Given the high preval...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7440632/ https://www.ncbi.nlm.nih.gov/pubmed/32817712 http://dx.doi.org/10.1371/journal.pone.0238091 |
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author | McQueenie, Ross Foster, Hamish M. E. Jani, Bhautesh D. Katikireddi, Srinivasa Vittal Sattar, Naveed Pell, Jill P. Ho, Frederick K. Niedzwiedz, Claire L. Hastie, Claire E. Anderson, Jana Mark, Patrick B. Sullivan, Michael O’Donnell, Catherine A. Mair, Frances S. Nicholl, Barbara I. |
author_facet | McQueenie, Ross Foster, Hamish M. E. Jani, Bhautesh D. Katikireddi, Srinivasa Vittal Sattar, Naveed Pell, Jill P. Ho, Frederick K. Niedzwiedz, Claire L. Hastie, Claire E. Anderson, Jana Mark, Patrick B. Sullivan, Michael O’Donnell, Catherine A. Mair, Frances S. Nicholl, Barbara I. |
author_sort | McQueenie, Ross |
collection | PubMed |
description | BACKGROUND: It is now well recognised that the risk of severe COVID-19 increases with some long-term conditions (LTCs). However, prior research primarily focuses on individual LTCs and there is a lack of data on the influence of multimorbidity (≥2 LTCs) on the risk of COVID-19. Given the high prevalence of multimorbidity, more detailed understanding of the associations with multimorbidity and COVID-19 would improve risk stratification and help protect those most vulnerable to severe COVID-19. Here we examine the relationships between multimorbidity, polypharmacy (a proxy of multimorbidity), and COVID-19; and how these differ by sociodemographic, lifestyle, and physiological prognostic factors. METHODS AND FINDINGS: We studied data from UK Biobank (428,199 participants; aged 37–73; recruited 2006–2010) on self-reported LTCs, medications, sociodemographic, lifestyle, and physiological measures which were linked to COVID-19 test data. Poisson regression models examined risk of COVID-19 by multimorbidity/polypharmacy and effect modification by COVID-19 prognostic factors (age/sex/ethnicity/socioeconomic status/smoking/physical activity/BMI/systolic blood pressure/renal function). 4,498 (1.05%) participants were tested; 1,324 (0.31%) tested positive for COVID-19. Compared with no LTCs, relative risk (RR) of COVID-19 in those with 1 LTC was no higher (RR 1.12 (CI 0.96–1.30)), whereas those with ≥2 LTCs had 48% higher risk; RR 1.48 (1.28–1.71). Compared with no cardiometabolic LTCs, having 1 and ≥2 cardiometabolic LTCs had a higher risk of COVID-19; RR 1.28 (1.12–1.46) and 1.77 (1.46–2.15), respectively. Polypharmacy was associated with a dose response higher risk of COVID-19. All prognostic factors were associated with a higher risk of COVID-19 infection in multimorbidity; being non-white, most socioeconomically deprived, BMI ≥40 kg/m2, and reduced renal function were associated with the highest risk of COVID-19 infection: RR 2.81 (2.09–3.78); 2.79 (2.00–3.90); 2.66 (1.88–3.76); 2.13 (1.46–3.12), respectively. No multiplicative interaction between multimorbidity and prognostic factors was identified. Important limitations include the low proportion of UK Biobank participants with COVID-19 test data (1.05%) and UK Biobank participants being more affluent, healthier and less ethnically diverse than the general population. CONCLUSIONS: Increasing multimorbidity, especially cardiometabolic multimorbidity, and polypharmacy are associated with a higher risk of developing COVID-19. Those with multimorbidity and additional factors, such as non-white ethnicity, are at heightened risk of COVID-19. |
format | Online Article Text |
id | pubmed-7440632 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-74406322020-08-26 Multimorbidity, polypharmacy, and COVID-19 infection within the UK Biobank cohort McQueenie, Ross Foster, Hamish M. E. Jani, Bhautesh D. Katikireddi, Srinivasa Vittal Sattar, Naveed Pell, Jill P. Ho, Frederick K. Niedzwiedz, Claire L. Hastie, Claire E. Anderson, Jana Mark, Patrick B. Sullivan, Michael O’Donnell, Catherine A. Mair, Frances S. Nicholl, Barbara I. PLoS One Research Article BACKGROUND: It is now well recognised that the risk of severe COVID-19 increases with some long-term conditions (LTCs). However, prior research primarily focuses on individual LTCs and there is a lack of data on the influence of multimorbidity (≥2 LTCs) on the risk of COVID-19. Given the high prevalence of multimorbidity, more detailed understanding of the associations with multimorbidity and COVID-19 would improve risk stratification and help protect those most vulnerable to severe COVID-19. Here we examine the relationships between multimorbidity, polypharmacy (a proxy of multimorbidity), and COVID-19; and how these differ by sociodemographic, lifestyle, and physiological prognostic factors. METHODS AND FINDINGS: We studied data from UK Biobank (428,199 participants; aged 37–73; recruited 2006–2010) on self-reported LTCs, medications, sociodemographic, lifestyle, and physiological measures which were linked to COVID-19 test data. Poisson regression models examined risk of COVID-19 by multimorbidity/polypharmacy and effect modification by COVID-19 prognostic factors (age/sex/ethnicity/socioeconomic status/smoking/physical activity/BMI/systolic blood pressure/renal function). 4,498 (1.05%) participants were tested; 1,324 (0.31%) tested positive for COVID-19. Compared with no LTCs, relative risk (RR) of COVID-19 in those with 1 LTC was no higher (RR 1.12 (CI 0.96–1.30)), whereas those with ≥2 LTCs had 48% higher risk; RR 1.48 (1.28–1.71). Compared with no cardiometabolic LTCs, having 1 and ≥2 cardiometabolic LTCs had a higher risk of COVID-19; RR 1.28 (1.12–1.46) and 1.77 (1.46–2.15), respectively. Polypharmacy was associated with a dose response higher risk of COVID-19. All prognostic factors were associated with a higher risk of COVID-19 infection in multimorbidity; being non-white, most socioeconomically deprived, BMI ≥40 kg/m2, and reduced renal function were associated with the highest risk of COVID-19 infection: RR 2.81 (2.09–3.78); 2.79 (2.00–3.90); 2.66 (1.88–3.76); 2.13 (1.46–3.12), respectively. No multiplicative interaction between multimorbidity and prognostic factors was identified. Important limitations include the low proportion of UK Biobank participants with COVID-19 test data (1.05%) and UK Biobank participants being more affluent, healthier and less ethnically diverse than the general population. CONCLUSIONS: Increasing multimorbidity, especially cardiometabolic multimorbidity, and polypharmacy are associated with a higher risk of developing COVID-19. Those with multimorbidity and additional factors, such as non-white ethnicity, are at heightened risk of COVID-19. Public Library of Science 2020-08-20 /pmc/articles/PMC7440632/ /pubmed/32817712 http://dx.doi.org/10.1371/journal.pone.0238091 Text en © 2020 McQueenie et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article McQueenie, Ross Foster, Hamish M. E. Jani, Bhautesh D. Katikireddi, Srinivasa Vittal Sattar, Naveed Pell, Jill P. Ho, Frederick K. Niedzwiedz, Claire L. Hastie, Claire E. Anderson, Jana Mark, Patrick B. Sullivan, Michael O’Donnell, Catherine A. Mair, Frances S. Nicholl, Barbara I. Multimorbidity, polypharmacy, and COVID-19 infection within the UK Biobank cohort |
title | Multimorbidity, polypharmacy, and COVID-19 infection within the UK Biobank cohort |
title_full | Multimorbidity, polypharmacy, and COVID-19 infection within the UK Biobank cohort |
title_fullStr | Multimorbidity, polypharmacy, and COVID-19 infection within the UK Biobank cohort |
title_full_unstemmed | Multimorbidity, polypharmacy, and COVID-19 infection within the UK Biobank cohort |
title_short | Multimorbidity, polypharmacy, and COVID-19 infection within the UK Biobank cohort |
title_sort | multimorbidity, polypharmacy, and covid-19 infection within the uk biobank cohort |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7440632/ https://www.ncbi.nlm.nih.gov/pubmed/32817712 http://dx.doi.org/10.1371/journal.pone.0238091 |
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